India has seen over 7,50,000 cleft surgeries performed by Smile Train in 25 years, averaging 30,000 annually, the highest by any organization. Despite this, a significant backlog of corrective surgeries persists, with an estimated 36,000 babies born with cleft abnormalities yearly and 1.75 million children needing unrepaired clefts. Other NGOs have collectively aided an additional 1.5 million children. Challenges include a lack of national data, inadequate parental counseling, and high surgery costs, contributing to a substantial burden of untreated clefts.